A 44-year-old man presented with painless episodes of blurred vision in his left eye (LE) for days.
Initially all examinations were normal without direct or indirect signs of pathology.
However, thanks to the progressive increase of the episodes we could observe a central subepithelial cyst initially of 1mm, posteriorly annular and by transepithelial lesions, outside the visual axis, tenuous digital footprint lines.
1.
With the diagnosis of unilateral keratopathy presumptive, we performed corneal topographies and pachymetries to confirm our hypothesis.
Given the histopathology underlying DHC, where the epithelial basal membrane is precipitating, we related blurred vision seizures with epithelial detachments in the corneal thickness, top refractive crisis.
Thus, pachymetric data in asymptomatic moments will be: 574μ in RE and 584μ in OI and during episodes: 600μ in OI (US Alcon pachymeter).
In the topographic images corresponding to Fig. 1, we will observe a corneal flattening and irregular astigmatism only in OI (corneal CT CA-100 Corneal Analyser Topcon).
We will also find a hypermetropic change of +1.00 diopters of refractive spherical change.
After administering NaCl 0.5% eye drops twice daily, we observed reversal of symptoms and topographic changes.
After 1 year we observed a greater topographic stability although occasionally it comes with visual borrosity sprouts.
